Category: Health

Many of us are naive enough to believe that an infection is something which yields an illness of a specific duration. Colds and flus pass through our lives with a fairly specific duration. We understand there are things which are chronic but generally we expect them to come to an end. Such was the case when I receive a visit from Lyme Disease and the spirochetes which cause it.

An Erratic Course of Diverse Symptoms

Diverse symptoms confused the picture. I thought I was getting old. Well, I was but that was not the primary issue. Finally my wife told me I had most of the symptoms suffered by her friends who had Lyme Disease. The blood test I took was negative. Later I learned the blood test is completely unreliable but practitioners were too often relying on it anyway. I never had the bullseye rash and evidently most people don’t. We were told we got it from ticks and now they have decided mosquitos also convey it. Finally I tried a course of antibiotics anyway and suddenly was getting my life back. It was clear I had Lyme Disease and got better. My course was a year without major symptoms and then a year of barely perceptible steady decline.

What I didn’t expect was that I would then suffer a seemingly free year and then a decline again. That pattern repeated again and my denial was finally broken when the fourth episode made it clear to me that I had a chronic disease.

Unfortunate Revelations

I was very disappointed. Over ten years I learned that not only did we have an unreliable blood test but that there was no vaccine for humans. There was a vaccine for dogs but pharmaceutical companies didn’t think it was profitable enough for humans. And while the epidemic infection raged on there was denial in the medical profession.

Endless List off Symptoms

No, there are not consistent symptoms. The spirochetes can attack anywhere in the body with unpredictable durations. My toes curled up and the damage was serious enough to require multiple surgeries. And now that I’m having it fought with a wide range of medications I suffer changing symptoms each day. Yes, there is fatigue, sudden joint swelling, aches and pains, brain fog and on and on. And I’ve learned that the little beasts can adapt so they are resistant to the most commonly used antibiotics. In one course the antibiotic suddenly stopped working. These creatures can put up a shell which protects them. But there is a way to pierce the shell if the physician is knowledgeable about it.

Go online and Google Lyme Disease. It is an eye opening experience.

An Uncertain Future

Quite frankly i feel had and can’t project my outcome. But this should not have happened and the epidemic should havebeen contained early on. It is clearly time to improve our health care system and deal with a pharmaceutical industry which needs firm regulation. People are being victimized by out of control costs and poor attention to realistic needs.

It Feels Like An Infestation (Which It Is)

What is distinct about this disease process is that I can feel the reaction and resistance of the spirochetes. It feels like they are fighting back but with a variable arsenal of resistance. We tend to see an invading organism as being somewhat passive and that it can be overwhelmed. But in this instance they are not passive and have a variety of tactics. It is almost like there is an intelligence with an arsenal. And we, as humans, are far behind them. It is like living in a science fiction story.

Recommendations

My recommendations include not assuming the blood test is reliable, if you don’t see the bullseye rash don’t assume you haven’t been infected. Understand that medication may suddenly stop working. Know that symptoms may change very slowly and a return of Lyme may take months before you understand it is back. Understand that there are no typical symptoms and any sudden changes may reflect the disease. Above all, don’t be passive. If you have any hints of infection, study it on line and be vigilant. It is not immediately lethal but can cloak your life in fatigue and serious ongoing consequences. May the force of resistance be with you. And let’s hope our understanding and response improves.

What to do? Seek treatment at once. Study the latest information on line. Be vigilant. Stay with treatment beyond the basic period. Response is still developing so stay on it and continue to seek information.

The above is the title of an important book by Thomas Szasz. Mental illness still dominates a significant portion of our health care system and it still has major conceptual problems. Of course, as a clinical psychologist, I was schooled in it. I actually came to love Carl Jung’s work a lot more than Sigmund Freud’s but his work still dominates.

Alternative Realities

And so we again return to where we live on the cusp. Over the decades I found nonphysical problems related to mental and cognitive issues to be far removed from “illness” and often nuanced. And when we move away from the dominant model, we find suitable alternatives. Unfortunately the insurance industry dominates the field and therefore may dictate treatment or at least what it is called. What it is called will often influence what is done. Substantial reform is needed.

Some of the Issues

When my wife and I personally confronted issues for remarried families (aka stepfamilies) we learned important lessons. An important initial lesson was that the process is a matter of adjustment, not psychopathology. Certainly there were some people with substantial disturbance from other causes but we learned to begin with our model of adjustment. Thecouple was focused on initially. Too often the mother or stepmother was put in therapy as if they were the problem although they may have shown the greatest distress initially. And we were resistant to putting children in therapy because adjusting to a new family was not pathological in almost all cases. Because of our approach we could structure an information system and found that generally the family could take over adjustment and handle their own future after very few sessions. See our book Stepfamilies: Professionals and Stepcouples in Partnership by Mala S. Burt, M.S.W. and Roger B. Burt, Ph.D.

Another major issue is what is termed post traumatic distress disorder or PTSD. The military is wrestling with removing the word disorder because it proves to be a bar to veterans getting help with their adjustment. Does anyone really believe that someone should go to war and kill people daily or risk being killed daily while suffering stress and not need to cope with management and an enduring reaction. I shared my perception with some friends who were veterans and found them in tears when I suggested they were not “sick” although there were still issues decades after their war experience.

Enduring and Broad Issues

Those are just two examples of the reality of a world far more nuanced than what is described as mental illness. We can go on between things like personality diversity, numerous personal management needs as we pass through stages of our life. When I first came into the field the predominant viewpoint was that our development was finished in early adulthood. Absurd.

Management of life experience continues throughout life and it would be best if we approached our lives in that fashion. Take an area of life experience and we see that there is change, stress and adaptation. It would help if we defined a type of insurance that was appropriate and took these issues out of the hands of insurance companies focused exclusively on profit.

Life on the Cusp

Yes, here is that cusp again. Each of us is different with a raft of different experiences. We work for stability and commonality and often success. But it would help if we understood the richness of our diversity in the sense that much of the issues are not pathological and that our views from the cusp feed creativity, diversity and innovation. And life can be difficult, even jarring. From time to time we need to seek expertise and guidance but we generally do not need to cast it all into psychopathology. There are problems out there with profound biological origins where the person needs substantive help but very often management and guidance are what is needed.

Even if the actualization of a thought is distant or unlikely, there are times when some things have to be said.

Here is today’s dream.

The Elder Tsunami

The “advanced” economies of the world are facing the rapid aging of their populations which means a growing burden on the societies as a whole. The birth rate is often low and getting lower which means less familial and societal support for the elderly. Who will take care of them as they age and become frail? Family is often distant or members few in number.

Time was that we lived in close family groups. No more. Instead we are fragmented. We need a realistic national dialogue about solutions. Perhaps, as the neocon obstruction dissipates we may see improved governmental programs, but it seems no matter what, it will be insufficient or impossibly expensive. And I must add that Paul Mason’s book Postcapitalism, that directs our attention the future, is making my blood run cold. It is a complex and dense book but each area he touches on is being validated by current events. But the true import of the coming changes in the world economic system is not being recognized publicly—yet.

Certainly there are ideas out there to mitigate the coming trials. One alternative is social.

Societal Commitment

The Elderly for Each Other

I’m impressed by the progress that Habitat for Humanity has made nationally. There can be other forms of programs with societal support. The most likely source for the elderly is each other. Retirement is reached and then often there are healthy years before the inevitable decline. When I was working on my doctorate at Duke they finished a study which described a two year major decline before death that was common. Prior to that time, before the final decline the recently retired elderly could become more of a formalized volunteer force. It already happens somewhere, sometimes, but could be expanded.

The Elderly for the Young

In later years, having a cause is also useful. One cause I would recommend is making the commitment to support the efforts of a younger generation. The future for the elderly dims but there is reason to support younger generations. I don’t mean to say that these things don’t happen. What is at issue is the societal institutionalization of an ethos where we as elderly focus more strongly on our collective wellbeing whether that is for the elderly or for the ones who will remain. We have not been doing this well.

System Efficiency and Personal Management

And then there is the matter of health. Another thing we must do is to finally create a less expensive and more efficient health care system. Currently we have a very haphazard system which is expensive. Each of us experiences it on a regular basis. And included in these changes for the health care system needs to be a change of viewpoint by the elderly. Many have been trained over the decades to assume that the medical personnel will define what must be done and they adopt a passive stance. It is time to change that societal viewpoint so that we take the highest form of responsibility for our own care informationally and by action.

In Summary

In short, I would like to see a societal change in which the elderly, as they go through the later stages of life, work more closely together for mutual benefit. Secondly we should see to it that there is more organized societal support for the generations coming up. It is clear Millenials have felt overlooked and that needs to change. And the third item is long overdue reform of the health care system.

I know the response in many quarters will be that these goals are unrealistic or are already being undertaken. My response is we have not done enough and can do much more effectively.

We are a nation in crisis currently and not the least of the crises is our health care system. The enduring battle to reduce if not cripple government has taken its toll. We are the only developed country without an advanced health care system for all its citizens. And even what we have is under attack. Our system is inefficient and costly. Even if you are well off and well insured you immediately see problems.

And now that the government is under continuing attack we may see the collapse of small hospitals in rural areas. It would make the system even worse.

Seeing Problems First Hand

A few years ago I began to suffer mysterious and ephemeral problems and began a search for a cause. It turned out that I had Lyme Disease which had been poorly studied and is now epidemic. That was a major indicator of medical shortsightedness in itself. But then the problems became more obvious. I saw three separate physicians and each ordered a blood test (which we now know was virtually useless). When the results came in I found they were all the same tests. What a waste.

In France the public carries a data card and all results go on it. If we had such an efficient system the second physician would have had the results and there would not have been a second or third set of tests.

Floundering Over the Years

I am now considered to be a chronic Lyme Disease sufferer. It has been ten years since I believe I contracted the illness and I’m in my fourth return of the disease. This time my treatment will be more protracted. I can’t fault the medical people who have tried to help but the research has been abysmal and denial has been widespread. The stories of problems are endless.

Each of us has our own stories of problems, failures and inefficiencies. And the mental health field is no different. In a later post I’ll focus on one notable issue I became centrally involved in.

Failure on the Horizon

Many of us are looking at health care systems around us failing or on the verge of failing. As noted above, poorer, rural areas are particularly vulnerable in present circumstances. If those hospitals close, the effects will be devastating and the consequence will echo down the generations.

And currently we see areas which are very vulnerable and I saw a very specific area decades ago and it has not gotten any better. When I went to work in the impoverished area in the inner city of Baltimore our young staff learned quickly that the greater threat to “mental health” was poverty because of the depression and anxiety. But our seniors held fast to their desire for centralized systems rife with long term therapy and medications which served our people in the inner city poorly. I’ll leave it there for now. The sad tales go on and on.

But There Is Hope

Suddenly we are seeing an uprising in America. Our young are proclaiming “Enough Is Enough” and women are proclaiming “Me Too” in regard to sexual harassment and at the same time we are seeing a reenergized civil right movement. Now we can see the distinct possibility of vision and attention to the realities for our future. And health care is an essential part.

It has not yet been described as such, but it would seem we are on the verge of a national reformation. We appear to be suffering conflicts with no solutions immediately on the horizon. It is often dismissed as political but we have to suspect we are dealing with more fundamental issues.

The reaction to recent mass shootings is just one indicator of a national crisis. We are looking at demographic change looming large even as a major party seems to be in the process of collapsing. Now is a time for us to do a multilevel reevaluation on many fronts.

Public Safety and Guns

At the forefront is the issue of needed changes regarding our rules about guns. That means what type of guns should be permissible for possession outside of the military and what rules there need to be related to possession in general.

With all the discussion I have not once heard a meaningful discussion regarding the second amendment. The amendment was about the maintenance of a militia in a newborn country that did not have a standing functional army. Somehow it has become transformed into something else entirely.

In broad strokes we need to address matters of public safety as they relate to gun possession and related restrictions. That means we will also have to address ideological issues as they relate to the wellbeing and the future of our country.

Personal Dysfunction in a Society

But for me as a psychologist, I see another set of issues related to what we call mental health. It is brought up regarding guns and has sets of problems of their own. As noted, we originally applied the disease model as a way to remove issues of personal functioning from the belief in demonic possession. Our emotional and cognitive functionality did not belong in the religious arena but using the medical model has serious problems in its own right.

Many of the shooters in recent massacres were victimized by family history, distorted religious zealotry and probably sexual identity confusion among many other issues. But the question of how we address public safety leads us into a complex arena. And in that regard the disease model offers little clarify. It is supposed to instruct us about the nature of the problem, what procedures to use to deal with it and what medication is indicated if any. In fact, we must separate “mental illness” from the issue of gun management. They are related but there are many other issues involved.

Designing a Helping System

Our health care system is often dysfunctional, especially when corporate profit guides response.The physical health system and the mental health systems need serious attention and redevelopment.

In the larger picture we need to go back to fundamentals and design the model of how to relate to what are currently called mental health issues. They may be biochemical, stress related, developmental, chemically induced and so forth. Then we need to deal with how to respond and what help to offer. A long overlooked reassessment would take considerable time and even then will prove difficult when it comes to public safety. The issue will always be how to make functional help available and how systems can be designed to serve the sufferer and the public.

Reexamining Fundamentals

It would seem, at this time of what I believe will be national reformation, we should be reexamining fundamentals on many fronts. And my special interest is in reforming and completely revising the use of the outdated model of mental illness. How to respond to dysfunction and distress in human life is complex and that includes our response to drug addiction and abuse. Prevention is related to availability and utilization of services. When we tell people they are “sick” it may turn them away from the guidance and help they need. We attached the D to PTSD and turned it into a disorder when it is, in fact ,a predictable stress reaction among other things. It goes beyond a reaction to the experience of war and now we can see effects on our school children because of the recent shootings. The D proves to be a barrier to help and understanding. We can throw money at these issues but it would seem best to begin by reevaluating our approaches.

Each of us can be placed on dimensions of a set of behaviors and processes. When there is mental illness is a matter of dispute and fashion. When mental illness is defined, too often it is a function of funding and professional achievement. That sounds obscure, but think about it for a moment.

When community mental health blossomed, we learned, at least in inner city poverty, that poverty is stressful (seriously?) if not just plain overwhelming. The social workers were closest to the truth and saw our intervention as “case management”. People get depressed and anxious when they are overwhelmed and when we helped them manage their difficult lives they became less anxious and less depressed. In a poverty environment it is appropriate to be deeply concerned or even terrified regarding the future of your children.

The senior professionals above us wanted the grant money, the status and wanted to perpetuate the establishment. The young staff saw things very differently.

Guidance and Management

Through all my professional experiences I have come to see humans as functioning on a series of dimensions which instructs our personal development, defines, guides or disrupts our functioning. Stress exists and causes serious functional problems. Somewhere in there are biologically based issues and without a doubt most of us need guidance from time to time. And some people benefit from exploration of the self which they may find in some form of what is called insight therapy.

Sorting Out Reality

Overall, I would like to see us dismiss the concept of mental illness entirely. We can focus on problems associated with biochemical processes when essential and detach severe reactions caused by trauma. It would take time to reformulate the field but we certainly could become more effective and husband our resources. Problem solving and management are basic parts of all human endeavors. What do you think would happen if we started to diagnose corporations or political candidates? I doubt there would be much approval by the objects of such activities.

What happened at Orlando was a terrible tragedy but also opened a door where we find the opportunity for reevaluation on a variety of fronts. I know I’m crying out in the wilderness because there is a huge investment of various kinds in maintaining the status quo. But I can dreams can’t I? There might be a world where we are honest with ourselves, where we can be more efficient and effective and accept our complexity and variety of potentials.

Two definitions come to mind at once as we look at this post. Psychiatry is defined as: “the study and treatment of mental illness, emotional disturbance, and abnormal behavior.” Psychology has a variety of definition but I prefer: the study of human and animal behavior. The numerous other definitions suggest we aren’t actually sure what psychology is and I share that position. in fact, there is even a philosophical element which suits me just fine.

In Clinical Psychology

When we move on to the clinical area we quickly brush up against mental illness and as a student we quickly learn that diagnoses are generally expected. But how does mental illness fit with the broader definition of the study of human behavior. It seems like it must be a subcategory. What I found was that it is a restless subcategory and won’t keep its mouth shut.

Or at least it becomes a problem when we visit that devise place called the real world. And, of course, I believe in the cusp of reality which means I have questions. Are you hearing the pounding of philosophy at the door?

Then There Is Diagnosis

Freud defined a great deal of what is psychiatry and we entered a world of illness which required treatment and so there must be a diagnosis. The whole process was to be applauded because it moved emotionally disturbed people out of intervention for possession by demonsgenerally under the oversight of the church. They were in better, more compassionate, hands then. But not all of mental health people were devoted to Freud’s teachings. And that included Carl Jung who took us out into the world at large in a variety of ways. I won’t try to explore him. Take a look yourself.

What’s the Point?

It seems we are lost in a forest of exploration. There are those who believe in specific diagnoses for mental illness and in some case it yields helpful intervention. But there are others of us who believe it is far more complex than that. Sometimes diagnoses lead us down narrow corridors and sometimes it is more effective to shy away from an illness model and take the path to looking for functional factors and something I will call life management.

In This Age

Isn’t it interesting that as we rush forward into the future we are still mired in definitions and differing camps of adherents when it comes to what we call health care. At least we have latched onto prevention and a variety of preventive procedures. Those continue to need exploration and so do our responses to things happening to us that deserve attention.

That’s enough of the meshing of philosophical exploration with the real world. In future posts I’ll move deeper into the world of what we call mental illness and alternative forms of response which includes what I call self management.